title: Factors affecting wound leakage in 23-gauge sutureless pars plana vitrectomy.
abstract: OBJECTIVE
  To evaluate risk factors for sclerotomy leakage in 23-gauge sutureless pars plana vitrectomy in 219 patients.
  
  
  METHODS
  Nested case-control study involving 48 patients with wound leaks (visible on-table sclerotomy leakage requiring sutures) and 171 control subjects without wound leaks. Patients received either a conventional sclerotomy incision at 45°, which was then changed to 90° midincision, or an extremely oblique sclerotomy incision (OSI) at 10°, which was then changed to 30° midincision. Risk factors studied included age, gender, laterality, surgical duration, sclerotomy incision (OSI vs. conventional sclerotomy incision), preoperative diagnosis (macular vs. nonmacular), history of vitrectomy, and primary surgeon (attending vs. supervised resident).
  
  
  RESULTS
  Multivariate logistic regression analysis found significant (P ≤ 0.05) protective factors for wound leakage including OSI, macular preoperative diagnosis, no previous vitrectomy, and female gender. Surgical duration at least 45 minutes was considered a borderline risk factor.
  
  
  CONCLUSIONS
  Using an extremely OSI versus a conventional sclerotomy incision reduces the incidence of wound leakage postoperatively because of its self-sealing effect. Other factors that contribute to wound leakage, such as increased surgical duration and nonmacular diagnosis, may be indirect measurements of extensive trocar rotation, causing wound leakage despite the use of an OSI.
authors.affiliation: Department of Ophthalmology, University of Mississippi Medical Center, Jackson, Mississippi 39216, USA.
authors.forename: Albert L
authors.initials: AL
authors.lastname: Lin
authors.forename: Deepta A
authors.initials: DA
authors.lastname: Ghate
authors.forename: Zachary M
authors.initials: ZM
authors.lastname: Robertson
authors.forename: Patrick Sean
authors.initials: PS
authors.lastname: O'Sullivan
authors.forename: Warren L
authors.initials: WL
authors.lastname: May
authors.forename: Ching-Jygh
authors.initials: CJ
authors.lastname: Chen
mesh_terms: D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007906:Lens Subluxation / Q000601:surgery*; D008297:Male; D008866:Microsurgery / Q000379:methods*; D008875:Middle Aged; D012164:Retinal Diseases / Q000601:surgery*; D012307:Risk Factors; D012590:Sclera / Q000473:pathology*; D012599:Sclerostomy / Q000379:methods; D013529:Surgical Wound Dehiscence / Q000209:etiology* / Q000601:surgery; D013536:Suture Techniques; D013997:Time Factors; D014821:Vitrectomy / Q000379:methods*